Filly Mbenga
Wake Forest
Summary
Claims Representative with New York Life Insurance Co, skilled in resolving complex disputes and streamlining claims processing. Expertise in negotiation and detail-oriented analysis leads to significant operational enhancements. Developed effective guidelines and produced insightful reports, ensuring compliance and exceptional customer service in high-pressure settings.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Claims Representative
New York Life Insurance Co
Charlotte
05.2023 - Current
- Managed claims process from initiation to resolution for diverse clientele.
- Reviewed and analyzed claim submissions for accuracy and compliance.
- Collaborated with internal teams to ensure timely adjudication of claims.
- Resolved complex claims disputes through effective negotiation strategies.
- Developed guidelines that streamlined claims processing and improved operational workflows.
- Generated reports analyzing claim trends to support strategic decision-making.
- Investigated discrepancies in claims documentation and provided resolutions.
- Maintained comprehensive records of claims processing activities to ensure compliance and facilitate audits.
Administrative Assistant
Mecklenburg health department
Charlotte
04.2015 - 04.2022
- Conducted individual nutrition assessments for clients in diverse communities.
- Educated families on healthy eating habits and food choices during counseling sessions.
- Coordinated with healthcare providers to ensure comprehensive client care and support.
- Facilitated group workshops to promote nutritional awareness and community engagement.
- Maintained accurate client records in compliance with organizational standards and regulations.
- Collaborated with local organizations to enhance program outreach and accessibility.
- Counseled clients on appropriate food choices within their budget constraints.
- Attended trainings related to nutrition counseling or public health initiatives.
- Educated participants about food safety practices such as proper storage and handling techniques.
- Assessed nutritional needs of clients, based on dietary history and anthropometric measurements.
- Attended monthly staff meetings to discuss program updates and changes in policy or procedure.
- Supported efforts aimed at improving service delivery outcomes for WIC participants.
- Facilitated breastfeeding support groups for pregnant women and new mothers enrolled in the WIC program.
- Ensured compliance with state and federal regulations governing the WIC Program.
- Provided nutrition education and counseling to WIC participants.
- Maintained accurate records of client visits, including demographic information, assessment results, and follow-up plans.
- Conducted outreach activities in the community to promote awareness of WIC services.
- Provided referrals to other community resources when needed.
- Researched calories and nutritional content of various meals and summarized data in comprehensive reports.
- Devised meal plans in line with patients' age, gender, diagnosis, cultural background and religious practices.
- Recommended appropriate feeding schedules and methods to meet nutritional needs and abilities.
- Reviewed records and assessed nutritional condition of at-risk residents, including individuals with unplanned weight changes to keep tabs on potential issues.
- Created new recipes based on organic, local food sources and promoted low-fat and low-sodium diets.
- Counseled pregnant women on nutritional requirements and suggestions for healthy diets.
- Referred patients to other relevant services to foster continuity of care.
Education
Master Of Science (M.S.) - Public Health
National University
San Diego, CA09.2017
Bachelor Of Arts (B.A.) - Health And Human Services
Wingate University
Charlotte, NC08.2015
Skills
- Negotiation and problem solving
- Attention to detail
- Time management
- Leadership
- Critical thinking
- Windows proficiency
- Adaptability
- Multitasking
- Conflict resolution
- Customer service
- Verbal and written communication
Certification
Monitoring and Evaluation
Timeline
Claims Representative
New York Life Insurance Co
05.2023 - Current
Administrative Assistant
Mecklenburg health department
04.2015 - 04.2022
Master Of Science (M.S.) - Public Health
National University
Bachelor Of Arts (B.A.) - Health And Human Services
Wingate University